Would you advocate the use of cost-per-QALY league tables to inform healthcare decision making? Justify your answer.

TOPIC: Cost-utility analysis and cost-benefit analysis

BACKGROUND

When making decisions under uncertainty, understanding the conceptual foundations of von Neumann-Morgenstern’s expected utility model would be useful. This model is based on the notion that if a decision maker’s preferences can be described by an expected utility function, the decision maker’s preferences over certain outcomes can be known by assessing the decision maker’s payoff from the certain outcomes. Preferences and outcomes can be measured using rating scales, standard gamble or time trade-off. An example of a measure of the value of health outcomes is quality-adjusted life-year (QALY). It is usually used in cost-utility analysis to calculate the ratio of cost to QALYs saved for a particular health care intervention. This is then used to make decisions in such a way that an intervention with a lower cost to QALY saved (expressed in terms of incremental cost-effectiveness ratio (ICER)) is being preferred over an intervention with a higher ICER. The results of cost-utility analyses using QALY are usually presented in the form of QLY league tables or rankings. But there are criticisms regarding the utility of cost per-QALY rankings since their utility can be difficult to justify under several scenarios although they can be useful for obtaining valid assessments of the value of current and new interventions.

Question:

Would you advocate the use of cost-per-QALY league tables to inform healthcare decision making? Justify your answer.

For this Assignment:

• Use Harvard format for all In-text citations and references.

• All sources must be scholarly and fully referenced (indicate the URL of sources where available).

• I request for plagiarism report.

• Use real life examples where applicable.

• The instructions for this assignment must be strictly adhered to.

Required Resources

• Morris, S., Devlin, N. & Parkin, D. (2012) ‘Chapter 11: Measuring and valuing health care output. In: Economic analysis in health care. 2nd ed. Chichester, England: John Wiley & Sons, pp. 253-285.

• Carr, A.J. & Higginson, I.J. (2001) ‘Are quality of life measures patient-centred?’, British Medical Journal, 322 (7298), pp. 1357-1360 [Online]. Available from: http://search.ebscohost.com.ezproxy.liv.ac.uk/login.aspx?direct=true&db=mnh&AN=11387189&site=ehost-live&scope=site (Accessed: 18 August 2010).

• Properties needed by measures used in clinical practice. British Medical Journal, 322 (7297) [Online]. Available from: http://www.bmj.com/content/suppl/2001/05/24/322.7297.1297.DC1(Accessed: 18 March 2014).